Upper limb impairments, process skills, and outcome in children with unilateral cerebral palsy.
Remo N Russo, Pawel P Skuza, Myriam Sandelance and 1 others
PMID 30775778WHAT IT FOUND
In 108 children with one-sided cerebral palsy, upper limb strength and movement control, plus task planning and organization, were most strongly tied to self-care independence.
Better affected-hand sensation supported manual ability, while spasticity was less directly linked.
Key findings
01Manual ability and process skills had significant positive direct links to independence in self-care, with standardized model path strengths of 0.47 and 0.63.
02Sensory function had a significant positive direct link to manual ability (standardized model path strength 0.52), and spasticity had a significant negative direct link to manual ability (standardized model path strength -0.44).
03Age and intellect had significant positive direct links to process skills, with standardized model path strengths of 0.53 and 0.33.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTs
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What it does not show
This was a cross-sectional model of associations, not a treatment study, so it cannot show that improving muscle power, sensation, spasticity, or process skills will improve self-care. The sample had 108 children, which is smaller than the generally suggested limit of 200 cases for structural equation modelling. Missing data were more common in the youngest children, and the AMPS motor scale may not fit very young children well. Some motor control measures have not been extensively validated, and reliability data for the measures used are not currently available. The model was not cross-validated in a larger independent sample. The main test of how well the model fit the data was significant, which is not desirable, although this test is sensitive to model size. The study used many ordinal clinical measures, which are clinically functional but not the most robust from a measurement-quality perspective.
Declared interests
No conflicts-of-interest or funding statement appears in the supplied article text. The publication metadata lists research support from a non-U.S. government source.
The easy way to misread this
Do not read this as proof that treating muscle power, sensation, or process skills improves self-care. The study was cross-sectional and modelled associations, so it cannot establish that any treatment caused the reported relationships.